Table 1.
FDA approved therapies
| Mechanism of Action | Biomarker | Outcomes | Significant Adverse Events | References | |
|---|---|---|---|---|---|
| Omalizumab | Blocks IgE interaction to FcεRI | ↑FeNO (> 19.5 ppb) ↑Peripheral eosinophils (≥200/uL) |
Decreased exacerbations Reduced IgE levels Improved quality of life |
Cardiovascul ar and cerebrovascu lar event risk | Hanania 2013 [6] Busse 2013 [7] Casale 2017 [4] Chipps 2017 [9] |
| Mepolizumab | Anti-IL5 | ↑Peripheral eosinophils (> 150 or 300/uL) or sputum eosinophilia (> 3%) | Decreased exacerbations Reduced prednisone dose Decreased blood and sputum eosinophils Improved quality of life |
Herpes Zoster; Helminth infections | Nair 2009 [10] Pavord 2012 [11] Liu 2013 [14] Ortega 2014 [13] Bel 2014 [12] |
| Reslizumab | Anti-IL5 | ↑Peripheral eosinophils (> 400/uL) or sputum eosinophilia (> 3%) | Decreased exacerbations Decreased blood and sputum eosinophils Improved FEV1 |
Helminth infections; CPK elevation | Castro 2011 [15] Castro 2015 [16] Corren 2016 [17] |
| Benralizumab | Anti-IL5Ralpha | ↑Eosinophils ↑FeNO |
Decreased exacerbations (higher eosinophilia more predictive of response) Improved FEV1 |
Helminth infections | Castro 2014 [18] FitzGerald 2016 [19] Bleecker 2016 [20] |